Yes, Broken Hearts Are Real, and They Can Mimic a Heart Attack

Maybe you’ve survived your fair share of heartbreak: Lost loves, lost friends, lost careers, deaths in the family.

But every once in a while, a perfectly healthy heart can stop functioning properly immediately following an emotionally stressful event, such as losing a loved one.

This condition, officially called takotsubo syndrome but also known as stress-induced cardiomyopathy or broken heart syndrome, can be triggered by any intense stress, not just heartbreak. Think the loss of a pet or family member, surviving a traumatic event or experiencing a major illness or injury. 

The condition is usually (thankfully) temporary, but it should still be taken seriously — because it often causes symptoms similar to those of a heart attack.  

Broken heart syndrome temporarily deforms the heart

Broken heart syndrome can happen to anyone, but it affects more women than men, especially those who are postmenopausal, potentially because declining levels of estrogen leave the heart more vulnerable.  

“Women with this condition show all the classic signs of a heart attack, like shortness of breath and chest pain, right up until they get to the cath lab,” says April Stempien-Otero, MD, a cardiologist who practices at the UW Medicine Heart Institute.

The cath lab, short for the cardiac catheterization lab, is where doctors discover not the blocked artery or coronary artery disease characteristic of a classic heart attack; instead, they see parts of the heart’s main pumping chamber, the left ventricle, bulging outward when it should be squeezing in.

This is because those sections of the ventricular wall are failing to contract and balloon out when the rest of the ventricle squeezes.

Broken heart syndrome is a mystery

Scientists don’t understand how or why broken heart syndrome happens and are still researching both its cause and its long-term consequences.

“The real mystery of this condition is that we still don’t know what causes it,” says Stempien-Otero.

Earlier studies theorized that stress hormones known as catecholamines were released into the blood during stressful events and stunned the heart, triggering its dysfunction. But newer research suggests that inflammation plays a significant role.

Other than factoring in age and gender, it’s hard to know who will get broken heart syndrome and who won’t; most people experience extremely stressful events and won’t develop heart-related issues.  

Broken hearts usually mend

Recovery from broken heart syndrome is typically quick: For most people, their hearts appear to return to normal shape and function within weeks. However, there is a small subset of people who can become gravely ill, and, even rarer, a few who will die.  

“People have always thought that broken heart syndrome came and it went — that it was a temporary stress-related event,” says Stempien-Otero.

But new research shows that there is more lasting damage to the heart than previously thought. Though the heart appears to have returned to normal, it may not function as efficiently and may be more vulnerable to failure over time. 

“The take-home message is that if you’ve recovered but continue to have symptoms of fatigue or shortness of breath, you should discuss these symptoms with your cardiologist,” says Stempien-Otero.

A cardiologist may recommend long-term use of protective medications that support heart function as well as regular echocardiograms to track its function.

And as to your psychological recovery …

“Most people recover from exposure to traumatic events within a few months,” says psychiatrist Mark Sullivan, MD, who works at the UW Medicine Heart Institute.

But if psychological symptoms continue more than a few months after a traumatic event, it may be appropriate to consult with a psychiatrist or psychologist, says Sullivan.

After all, stress — especially life-altering traumatic events or long-term chronic stress — is known to affect your health, heart health included. It can be hard to tell if symptoms are from a heart problem or a panic attack, for example.

Men get broken hearts, too

It's true that broken heart syndrome is more common among women than men. But in spite of being less likely to experience stress-induced cardiomyopathy, men are more likely to experience cardiac complications during their hospitalization. And new research shows that men with broken heart syndrome are more likely to experience cardiogenic shock — when your heart can’t pump enough blood to meet your body’s needs. They’re also more likely to die. 

What makes this research surprising is that patients with cardiogenic shock experienced worse outcomes not only during the acute phase of their illness but five years out. Research since then has suggested that cardiac dysfunction can persist in people who don’t go into cardiogenic shock, too, which is why it’s so important to take your symptoms seriously and work with a cardiologist.  

Future research will shed more light on the mysteries that still confound our understanding of this condition, but until then, remember that broken heart syndrome is still rare. If you’re having symptoms like chest pain or difficulty breathing, call 911 right away.  

“A lot of people experience stressful events and very few end up with broken heart syndrome,” says Stempien-Otero. 

This article was originally published February 14, 2019. It has been reviewed and updated with new info. McKenna Princing contributed to this article.